| NPI | 1598964041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: TX 26513575) |
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: IN 01063989A) |
| Enumeration Date | 2007-07-15 |
| Last Update Date | 2018-04-05 |